ObjectiveTo investigate the pathogenic spectrum and molecular characteristics of infectious diarrhea among children in Putuo District of Shanghai from 2018 to 2023， and to provide scientific basis for the prevention and control of infectious diarrhea in children. MethodsFecal samples from the cases visited sentinel hospitals for children’s diarrheal disease in Putuo District， Shanghai， were collected from January 2018 to December 2023. A total of 11 species of bacteria were isolated and cultured， and 5 species of viruses were detected by real-time fluorescent polymerase chain reaction （PCR）. The molecular typing of some positive strains was analyzed by the standard pulsed-field gel electrophoresis （PFGE） method. The polymerase-capsid protein linkage region of some norovirus-positive samples was amplified by reverse transcription PCR， and was sequenced and analyzed by bioinformatics software. The Chi-square test and Fisher’s exact probability test were used to compare the pathogen-positive rates in 2018‒2019 and 2020‒2023. ResultsOf the 707 cases of children with infectious diarrhea， the total positive rate was 47.67%， with a single bacterial positivity rate of 16.27%， a single viral positivity rate of 22.63%， and a mixed positivity rate of 8.77%， respectively. The dominant pathogens were rotavirus （10.75%）， norovirus （10.33%）， enteropathogenic Escherichia coli （8.06%）， Salmonella （6.36%）， enteroaggregative Escherichia coli （5.52%）， and Campylobacter （5.23%）. Bacterial infections were predominant in summer and fall， and viral infections were predominant in winter and spring. The total positive rate decreased in 2020‒2023 compared with that of 2018‒2019 （χ²=5.753，P<0.05）. Thirty-seven strains of Salmonella， 81 strains of diarrheagenic Escherichia coli， and 19 strains of Campylobacter were completed for the molecular typing analysis by PFGE， which were classified into 28， 80 and 18 banding types， respectively， with a wide range of banding similarity. Nineteen copies of norovirus GⅡ group gene sequences were analyzed and classified into 5 genotypes， which were mainly GⅡ.Pe-GⅡ.4 and GⅡ.P16-GⅡ.2 types. ConclusionRotavirus， norovirus， diarrheagenic Escherichia coli， Salmonella， and Campylobacter are the dominant pathogens of infectious diarrhea in children in Putuo District of Shanghai. The pathogen spectrum shows a trend of seasonal epidemic characteristics， with a diversity of molecular characteristics of some pathogens. Surveillance and monitoring on molecular characteristics of the pathogens of infectious diarrhea in children should be strengthened in different seasons， so as to provide a laboratory basis for the prevention and control of infectious diarrhea.

Objective To investigate the prevalence and molecular characteristics of Anaplasma infections in sheep and goats in Anhui Province in 2020, so as to provide insights into ovine anaplasmosis prevention and control. Methods A total of 355 fresh blood samples were collected from 7 sheep and goat farms in Linquan County of Fuyang City, Lixin County of Bozhou City, Yu'an District of Lu'an City, Wangjiang County of Anqing City, Nanling County of Wuhu City, and Tianchang City and Fengyang County of Chuzhou City in Anhui Province from June to December 2020. A. bovis and A. phagocytophilum 16S ribosomal RNA (16S rRNA) gene, A. ovis major surface protein 4 (MSP4) gene and A. capra citric acid synthase (gltA) gene were amplified using PCR assay in all blood samples, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was calculated in sheep and goats. In addition, the positive amplification products were sequenced and subjected to genetic evolutionary analysis. Results The overall prevalence of Anaplasma infections was 17.5% (62/355) in sheep and goats in Anhui Province, and the prevalence of A. bovis, A. phagocytophilum, A. ovis and A. capra infections was 2.8% (10/355), 2.5% (9/355), 2.5% (9/355), and 7.0% (25/355), while the prevalence of A. bovis and A. phagocytophilum, A. phagocytophilum and A. ovis, A. phagocytophilum and A. capra and A. bovis, A. phagocytophilum and A. ovis co-infections was 0.8% (3/355), 1.1% (4/355), 0.3% (1/355) and 0.3% (1/355), respectively. No Anaplasma was detected in the sheep and goat farms in Fengyang County, while at least three Anaplasma species were detected in other sheep and goat farms, with co-infections of multiple Anaplasma species identified. The prevalence of Anaplasma infections was 14.7% (24/163) in goats and 19.8% (38/192) in sheep, and the prevalence of Anaplasma infections was 31.0% (31/100) in goats and sheep under 6 months of age, and 12.2% (31/255) in goats and sheep at ages of 6 months and older, respectively. A. bovis, A. phagocytophilum, A. ovis and A. capra were identified in sheep and goats of different breeds and ages. Conclusions Multiple Anaplasma species infections were commonly prevalent in goats and sheep in Anhui Province in 2020, notably A. phagocytophilum, A. ovis and A. capra, which have zoonotic risks. Improved surveillance and prevention and control of Anaplasma infections are required in sheep and goats in Anhui Province.

Objective To observe the effects of Banxia Xiexin Decoction on intestinal microbes and 5-HT in ulcerative colitis(UC)model mice induced by drinking sodium dextran sulfate(DSS),and to analyze the mechanism of Banxia Xiexin Decoction in treating UC from the perspective of brain-gut axis.Methods 40 male C57BL6/J mice were randomly divided into control group,model group,positive drug(mesalazine)group and Banxia Xiexin decoction group.All mice except control group were induced by 2.5%DSS solution for 7 days to establish UC model.From the 8th day,mice in the above groups were given intragastric administration of sterilized water,mesalazine aqueous solution and Banxia Xiexin decoction aqueous solution.HE staining was used to observe histopathological changes of colon,ELISA to detect 5-HT content in serum,colon and brain tissues,and 16S rRNA sequencing to further detect the changes of fecal flora in model mice.Results Compared with model group,DAI index of experimental mice model group was significantly decreased after Banxia Xiexin Decoction intervention(P<0.05);IL-2,IL-4 and IFN-γ were significantly recovered(P<0.05).The histopathological score of proximal and distal colon was significantly decreased(P<0.01).Moreover,the peripheral 5-HT level was significantly decreased(P<0.05),but the central had an increasing trend.Results of intestinal flora showed that the relative abundance of Clostridium_sensu_stricto_1,unclassified_p__Firmicutes increased(P<0.05),while Lachnospiraceae_NK4A136_group,Lachnoclostridium,norank_f__Oscillospiraceae and Eubacterium_xylanophilum_group decreased(P<0.05).It was also found that there were significant correlations between intestinal microflora and peripheral and central 5-HT levels.Conclusion Banxia Xiexin Decoction could play a role in treating ulcerative colitis by improving the intestinal microbial composition structure of UC mice to reduce peripheral 5-HT levels and increase central 5-HT levels,thereby improving intestinal inflammatory response and relieving anxiety.

Objective:To explore the status quo of the readiness of evidence-based nursing practice for the maintenance and removal of children's central venous catheter (CVC) in 6 domestic medical institutions Pediatric Intensive Care Unit (PICU), analyze the obstacles faced by the application of CVC maintenance and removal evidence in PICU, so as to provide basis for formulating reform strategies.Methods:This study was a cross-sectional survey. In December 2019, 169 nurses from PICU of 6 medical institutions in Shanghai, Guangzhou, Shenzhen, Hangzhou, Xiamen and Hefei were selected by convenience sampling for investigation. The General Information Questionnaire and Clinic Readiness to Evidence-based Nursing Assessment (CREBNA) were used to evaluate the readiness of clinical nurses to evidence, organizational environment and promoting factors in the process of evidence-based practice. A total of 169 questionnaires were issued, and 169 valid questionnaires were recovered, with a valid recovery rate of 100%.Results:A total of 169 nurses were investigated in 6 evidence application sites. The total score of the multi center CREBNA was (136.96±15.33), which was 88.36% of the full score. The scores of the three dimensions were as follows: organizational environment (40.31±4.45), evidence dimension (53.43±6.14), and promoting factors (43.22±5.81). Four of the last five items in the score ranking were from the promoting factor, and the low score items in four places were all from the promoting factor.Conclusions:The best practice project of children's CVC maintenance in PICU is feasible. However, there are still some deficiencies in the preparation of various evidence application sites, especially in the promoting factors, which should be constantly improved to further promote and maintain the implementation of change.

OBJECTIVE：To establish a meth od for the simultaneous determination of 7 active components in Mori Australis Cortex and Mori Cortex from different sources in Chongqing area ，so as to provide reference for improving the quality control standards of Mori Australis Cortex and Mori Cortex and comparing the equivalence of their quality. METHODS ：HPLC method was used to determine the contents of neochlorogenic acid ，mulberroside A ，chlorogenic acid ，astragalin，kaempferol，morusin and isoquercetin in 58 batches of Mori Australis Cortex and Mori Cortex. The chromatographic column was Diamonsil C 18 with mobile phase consisted of 0.1％ formic acid solution-acetonitrile （gradient elution ） at the flow rate of 1.0 mL/min. The detection wavelength was 280 nm，column temperature was 30 ℃，and the injection volume was 10 μL. Using SPSS 22.0 software， independent sample t-test，principal component analysis and cluster analysis were used to analyze the content difference of the above-mentioned 7 active components in Mori Australis Cortex and Mori Cortex. RESULTS ：There was a good linear relationship between the peak area and the concentration of the above 7 active components （r≥0.999 0）. The RSDs of precision ，stability（24 h），repeatability，durability and recovery were less than 3％. The average contents of neochlorogenic acid ，mulberroside A ， chlorogenic acid ， astragalin， kaempferol， morusin and 023-58576130。E-mail：1025473978@qq.com isoquercetin in Mori Australis Cortex were 0.304，22.462， 1.730，1.308，1.593，2.842 and 0.657 mg/g，respectively. Those of Mori Cortex were 0.305，22.995，2.486，2.438， 2.916，4.158 and 1.264 mg/g，respectively. The results of independent sample t-test showed that only the content of kaempferol in the above 7 active components of Mori Australis Cortex and Mori Cortex had significant difference （P＜0.05）. The results of principal component analysis and cluster analysis showed that there was no significant difference in the contents of above 7 active components between Mori Australis Cortex and Mori Cortex. CONCLUSIONS：The established HPLC method is simple ，sensitive and accurate ，which can provide a reference for improving the quality control standard of Mori Australis Cortex and Mori Cortex. Mori Australis Cortex and Mori Cortex have certain quality equivalence in main active components ，and the Mori Australis Cortex from M. australis and M. cathayana can be used as a substitute for the Mori Cortex.

OBJECTIVE:To establish the method for simultaneous determinations of rutin,forsythin and platycodin D in Sangju ganmao pills.METHODS:HPLC-MS method was adopted.The determination was performed on Waters Atlantis C18 column with mobile phase consisted of acetonitrile-0.1％ formic acid (gradient elution) at the flow rate of 0.2 mL/min.The column temperature was set 35 ℃,and sample size was 10 μL.The ionization mode was electrospray ion,and the reaction mode was multi-reaction monitoring.By positive ion detection mode,the drying gas and nebuliser gas were all high purity nitrogen.The drying gas temperature was 270 ℃.The drying gas flow rate was 25 L/min.The sheath gas flow rate was 10 L/min.The capillary voltage was 4 500 V.The nozzle voltage was 2 000 V and the scanning time was 0.1 s.RESULTS:The linear range of rutin,forsythin and platycodin D were 0.010 82-2.164 μg/mL (r=0.999 7),0.010 18-2.036 μg/mL (r=0.999 4),0.010 27-2.054 μg/mL (r=0.999 7),respectively The limits of quantification were 1.250,0.260,2.720 ng/mL,and the limits of detection were 0.380,0.078,0.820 ng/mL.RSDs of precision,stability and reproducibility tests were all no more than 3.0％.The recoveries were 97.88％-99.88％ (RSD=0.72％,n=6),98.48％-103.13％ (RSD=1.91％,n=6),98.79％-101.41％ (RSD=1.05％,n=6).CONCLUSIONS:This method is simple,precise,stable and reproducible,and can be used for simultaneous determination of rutin,forsythin and platycodin D in Sangju ganmao pills.

Objective To study changes of serum inflammatory indicators,plasma and urine free amino acid of patients with chronic obstructive pulmonary disease.Methods A total of 62 patients with chronic obstructive pulmonary disease in our hospital from June 2014 to April 2016 were selected as observation group,62 healthy with physical examination in our hospital during the same time were selected as control group,the serum inflammatory indicators,plasma and urine free amino acid of two groups were compared,and the above indicators of observation group with different GOLD classifications and stages were compared too.Results The serum inflammatory indicators of observation group were all higher,and plasma free amino acid indicators were all lower than that of control group,and the seruminflammatory indicators and plasma free amino acid indicators of observation group with different GOLD classifications and stages showed significant differences (P ＜ 0.05),while the urine free amino acid indicators of two groups had no significant differences (P ＞ 0.05).Conclusion The change of serum inflammatory indicators and plasma free amino acid of patients with chronic obstructive pulmonary disease are obvious,and the influence of severity degree and disease stages for the expression are greater,while the urine free amino acid have no obvious fluctuation,so the detection value of serum inflammatory indicators and plasma free amino acid of patients with chronic obstructive pulmonary disease are higher.

Objective To study changes of serum inflammatory indicators,plasma and urine free amino acid of patients with chronic obstructive pulmonary disease.Methods A total of 62 patients with chronic obstructive pulmonary disease in our hospital from June 2014 to April 2016 were selected as observation group,62 healthy with physical examination in our hospital during the same time were selected as control group,the serum inflammatory indicators,plasma and urine free amino acid of two groups were compared,and the above indicators of observation group with different GOLD classifications and stages were compared too.Results The serum inflammatory indicators of observation group were all higher,and plasma free amino acid indicators were all lower than that of control group,and the seruminflammatory indicators and plasma free amino acid indicators of observation group with different GOLD classifications and stages showed significant differences (P ＜ 0.05),while the urine free amino acid indicators of two groups had no significant differences (P ＞ 0.05).Conclusion The change of serum inflammatory indicators and plasma free amino acid of patients with chronic obstructive pulmonary disease are obvious,and the influence of severity degree and disease stages for the expression are greater,while the urine free amino acid have no obvious fluctuation,so the detection value of serum inflammatory indicators and plasma free amino acid of patients with chronic obstructive pulmonary disease are higher.

Objective To investigate the effects of serum brain natriuretic peptide(BNP), procalcitonin (PCT) and lung function by tiotropium bromide combined with aminophylline in the treatment of senile chronic obstructive pulmonary disease.Methods A total of 82 cases of elderly patients with chronic obstructive pulmonary disease ( COPD) were collected and randomly divided into experimental group and control group with 41 cases in each group.Patients in the control group were treated by conventional treatment; patients in the experimental group were treated on the basis of the control group with tiotropium bromide combined with aminophylline.The lung function, respiratory condition and serum levels of PCT, BNP before and after treatment were determined, and the clinical efficacy and safety was compared.Results The effective rate of the control group (68.29%) was lower than the experimental group (87.80%) , with statistical significance ( P<0.05 ); compared with the control group after treatment, the forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC) and FEV1%pre of the experimental group significantly increased, dyspnea score decreased, 4 min walking test increased, serum PCT and BNP levels decreased in the experimental group, with statistical significance ( P<0.05 ). Conclusion Tiotropium bromide combined with aminophylline in the treatment of senile chronic obstructive pulmonary disease could reduce the serum BNP and PCT levels and improve lung function.

OBJECTIVE:To explore the effect of Compound pueraria tablets on the kidney tissues of diabetic nephropathy rats. METHODS:High sugar and lipid diet combined with intraperitoneal injection of streptozotocin were used to establish the model of diabetic nephropathy (DN). Normal control group was established. Model rats were randomly divided into model control group, positive control group(Irbesartan tablet),Compound pueraria tablets low-dose,medium-dose and high-dose [0.102,0.203,0.406 g/(kg·d)] groups(n were 8-10). The corresponding drugs were given,and fasting blood glucose(FBG)and 24 h urinary protein (Upro) were collected at 1st,14th,28th,42nd,56th day after treatment. SCr,BUN,TC,TG and KI were detected,and renal pathology was observed after the last dose. RESULTS:Compared with normal group,FBG of those groups were all increased after modeling,and 24 h Upro of them were all increased after 28th day (P<0.05 or P<0.01). Compared with model control group, FBG of Compound pueraria tablets medium-dose and high-dose groups were all decreased since 42nd day (P<0.05 or P<0.01), and 24 h Upro of Compound pueraria tablets groups were all decreased since 28th day(P<0.05 or P<0.01);BUN,TC,TG and KI of Compound pueraria tablets in medium-dose and high-dose groups were all decreased significantly,and SCr of 3 dose groups were all increased (P<0.05 or P<0.01). The morphological structure of renal cells was improved significantly in drug treatment groups. CONCLUSIONS:Compound pueraria tablets can correct lipid metabolism disorder,reduce Upro and improve renal func-tion,indicating certain protective effect on the kidney tissues of diabetic nephropathy rats.